Opinion: Pay now or pay later for autism care

Over the last few years I have sat by and watched as 23 other states passed autism insurance legislation. I’ve often wondered why Michigan isn’t one of them. These states recognized the medical, societal, family and business benefits, and faced the choice that comes with autism insurance legislation: Pay now, or pay later.

One in 110 children born today is affected by autism, the fastest-growing developmental disability, with symptoms and characteristics that vary from individual to individual. Many children struggle with social or communication skills and can only express their frustrations through unmanageable behavior brought on by everyday activities like a trip to the grocery store or a surprise visit by grandma.

Autism was once thought to be untreatable, but early intervention, diagnoses and therapy, such as applied behavior analysis, speech therapy or occupational therapy, can improve children’s functioning and give them the opportunity to be a contributing member of their family and society. But therapy is expensive, and health care plans in Michigan usually exclude proven medical treatment for autism.

Despite the strong medical evidence, fears about rising insurance costs continue to cloud the facts. A recently published article in the Journal of Autism & Developmental Disorders estimates that insurance premiums would only be affected by 1 percent — that translates into 55 cents per payer per month. That’s not a lot of money for invaluable gains to the children, their families and society.

What’s even more staggering is what autism costs society. According to the Archives of Pediatric and Adolescent Medicine, we pay $3.2 million to care for an individual with autism over his/her lifetime. The largest direct cost is adult care for individuals unable to work or live independently. The Autism Society estimates those costs can be reduced by two-thirds based on the 2007 Government Accountability Office Report on Autism — that’s a savings of more than $2 million.

Michigan businesses could also benefit from insurance coverage. Parents who have children with autism are leaving their jobs and moving to states with autism coverage because they can’t wait for Michigan to catch up. Others are forced to reduce their hours due to child care issues or need to stay home all together. Coverage would not only retain these employees but increase productivity.

Since the State of Michigan hasn’t yet passed autism legislation, families are left with a difficult choice — accumulate sometimes overwhelming debt after spending as much as $50,000 per year in therapy, or forego treatment and accept that their child may never be able to overcome his/her symptoms and, in some cases, require lifelong care. In addition, the increase in stress families with autism experience takes a toll on their jobs, their health and often their marriage.

Pay now or pay later? We can continue to convince ourselves that we’re saving money by putting off this legislation. But by doing so, we choose to ignore the benefits of early intervention and make the choice to endure the potential consequences of a life dependent on government programs. Obvious benefits aside, children are in the middle of this debate — we need to give them every opportunity for a functional, productive and happy life.

I strongly encourage the Legislature to look at both sides of this issue and the true benefits to society. Perhaps then, Michigan will come alongside 23 other states that have already made a choice to put children as their highest priority.